Literature Review

Hospice leaders: palliative care through home health a limited prospect Hospice News; by Jim Parker; 8/6/26 Structuring palliative care payment through the home health benefit is the wrong approach, according to some hospice leaders. The U.S Centers for Medicare & Medicaid Services (CMS) in its proposed 2027 home health rule included language specifying that Medicare would cover community-based palliative care through the Medicare home health benefit. ... CMS indicated in a statement, “Therefore, in this proposed rule, CMS states that skilled palliative care services can be furnished and billed under existing Medicare home health benefits for eligible patients with serious illnesses.” ... But the home health chassis is not built to support the full range of interdisciplinary palliative care, some hospice leaders contend. The benefit also imposes certain limitations. For example, patients would need to be homebound. ...

Mandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomesJournal of Palliative Medicine; by Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder; 7/26Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Results: Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a "No" response. A "No" response was strongly associated with increased palliative care consultation ... , ACP documentation ... , hospice referral ... , comfort-measures-only orders ... , hospice disposition ... , higher inpatient mortality ... , and increased 30-day readmission ... Palliative care consultation occurred earlier among MSQ "No" than MSQ "Yes" encounters.

Safeguarding palliative and serious illness care in America The Lancet Regional Health - Americas; by William E. Rosa, Gina Piscitello, Diane E. Meier, Arif H. Kamal, Jean S. Kutner, Abby R. Rosenberg, Allison Silvers, Stacie Sinclair, Robert M. Arnold; August 2026If a society's greatness is measured by how it treats its most vulnerable, we live in discouraging times for the more than 13 million adults and 700,000 children with serious illnesses in the United States of America (U.S.). ... In this personal view, we describe three threats to specialty palliative care in the U.S., namely healthcare financing changes, increased privatization of services, and low prioritization of palliative care research in myriad contexts, including pharmaceutical and clinical trial research and development. We subsequently provide guidance for multi-sector actors to address these threats and mitigate harms while optimizing palliative care for U.S. populations.

Hospice's bad reputation amid fraud crisis will hurt patients, industry experts warn U.S. News & World Report; by Laurie Udesky and KFF Health News; 7/30/26... “The fraud situation has done a lot of damage to the reputation of hospices overall and undone a lot of the progress that had been made in destigmatizing hospice,” said Lauren Hunt, an associate professor at the University of California-San Francisco’s Philip R. Lee Institute for Health Policy Studies who focuses on hospice care. “Policymakers should pursue targeted strategies that root out fraud and abuse without overburdening the many providers who are doing the right thing.” ... Hunt said she’s heard from California healthcare providers who are reluctant to refer patients to hospice because they’re unsure the patients will receive high-quality care and from patients who don’t know which hospice providers they can trust. 

Quality domains in home-based pediatric hospice and palliative care: Adolescent and young adult perspectivesBMC Palliative Care; by Daniel H Grossoehme, Claire A Crawford, Jhansi Chandra Ellakula, Toluwalase Ajayi, Justin N Baker, Sarah Friebert, Lisa Humphrey, JillAnn Jarrell, Rachel Thienprayoon, Pamela S Hinds; 7/26Previous research with pediatric providers and caregivers concluded that pediatric hospice and palliative care have unique attributes. Not known is how adolescent hospice and palliative care patients understand quality palliative care. Methods: Semi-structured interviews with 10-26 year-olds who received home-based hospice and/or palliative care visits in the prior three years at six diverse sites in the United States. The results address an important gap by including adolescent/young adult patients' voices regarding delivery of home-based hospice and palliative care. Clinical implications include prioritizing and making time to build trusting relationships directly with the AYA, empowering them to participate in their care to the extent appropriate and prepare for transition to adult care when needed, providing support for family members, and training for all providers in generalist spiritual care.

Why traditional primary care fails frail elders and the future need for specialized models | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Bethany Snider; 7/29/26 Traditional primary care wasn't designed for today's frail elders—and that gap may be one of healthcare's greatest challenges. As America's population ages, healthcare leaders face an urgent question: Is the traditional primary care model enough to care for frail older adults with complex medical, functional, and social needs?  In Part One of this thought-provoking conversation, Chris Comeaux welcomes Dr. Bethany Snider, Chief Medical Officer of Everent Health, to explore why the future of serious illness care requires a fundamentally different approach. Together, they unpack the emerging concept of the frail elder practice—a longitudinal, interdisciplinary model that extends beyond office visits to meet patients where they are, both physically and emotionally.

Poverty level affects end-of-life care in adolescent and young adult cancer patients  Cancer Therapy Advisor; by Liam Andrew DAvenport, MA; 7/24/26 Adolescent and young adult (AYA) cancer patients from high-poverty neighborhoods face disparities in end-of-life (EoL) care, according to research published in the Journal of the National Comprehensive Cancer Network. AYA patients from high-poverty neighborhoods have more emergency department visits and hospitalizations, and less hospice use, than their low-poverty counterparts, study researchers reported. ... Eligible patients had been diagnosed with cancer and died between 12 and 39 years of age, and were enrolled in one of the participant health systems for more than 90 days prior to their death. 

The effect of palliative care involvement in vascular patients at the end-of-lifeJournal of Vascular Surgery; by Angela McCarthy, Kristy Wrana, Emma Triantafyllou, Ya-Huei Li, Carol Strycharz, Lindsay Lynch, Edward D Gifford; 6/26Vascular surgeons frequently manage critically ill patients and support complex end-of-life decision-making. Despite well-documented benefits of palliative care in serious illness, prior studies report that only 25% of vascular patients near the end of life received such support. Those without a palliative consult were more likely to undergo a code (18.0% vs. 6.6% ... ). After palliative consultation, the proportion of patients with a code status of do-not-resuscitate increased from 50.0% to 77.4%, and the proportion with a full code designation decreased from 50% to 22.6%  ... Patients with the goal of care to allow natural death increased to more than half of the patients from 18.4% after the palliative consultation ... These findings highlight an opportunity for vascular surgeons to proactively integrate palliative care, improving alignment between clinical interventions and patient preferences.

[Italy] Fever in a palliative care setting: Clinical insights and implications from a prospective observational cohort studyPalliative Medicine; by Stefania Cheli, Elena Angeli, Oscar Corli, Sofia Dinegro, Agostino Zambelli, Tania Carta, Romina Shazivari, Michaela Smolikova, Paolo Franceschi, Francesco Molà, Yara Silva Cruzeiro, Emilio Clementi, Andrea Gori; 5/26Fever is a frequent but complex symptom in adults with a limited prognosis, arising from multifactorial causes beyond infection. The study was conducted in an inpatient hospice palliative care unit within the Luigi Sacco Hospital in Milan, Italy (January and December 2024). Fever occurred in 40% of patients, with a median onset of 5.5 days after admission. In 39.7% of cases, fever was attributed to infections, mainly catheter-associated urinary tract infection. Its strong association with medical devices highlights the need for proportional, personalised interventions that primarily consider prognosis, symptom relief, and quality of life.

700 rural hospitals at risk of closing, by state Becker's Hospital Review; by Madeline Scheetz; 7/22/26 Seven hundred rural hospitals across the U.S., or about one-third of all rural facilities in the country, are at risk of closing due to severe financial challenges, according to a July 21 Center for Healthcare Quality and Payment Reform analysis. The analysis comprises 264 hospitals that are at immediate risk of closure, according to the report. In almost every state, rural hospitals are at risk of closure. In most states, more than 25% of rural hospitals are at risk and in 11 states, 50% or more are at risk. ... More than 100 rural U.S. hospitals have closed in the past decade, with 110 closing since 2015, according to the report. Fifty-three hospitals have ended inpatient services since the beginning of 2023 to qualify for federal grants only available to rural emergency hospitals.

Palliative Care team manifests dreams of butterbeer and Harry Potter Vanderbilt Health News, Nashville, TN; by Jill Clendening; 7/20/26 After Mike Guth and his family learned that his pancreatic cancer had advanced beyond treatment, the Vanderbilt Health Palliative Care team worked magic to make a dream trip possible. ... Mike, 53, a beloved high school social studies teacher in southern Indiana and father of four, was diagnosed with Stage 2 pancreatic cancer in early 2025. ... Mike has always loved the magical lore of Harry Potter, excitedly consuming the books and movies with their children (now adults). Mike perhaps seized inspiration from the plot twists of the fantasy series to say he still longed to visit The Wizarding World of Harry Potter in Orlando, Florida. With careful planning to manage symptoms and stay on top of hydration, the Vanderbilt Health Palliative Care team surprised the Guths and said his dream was doable. ... Palliative care physician Zack Watson, MD described, "for him to have that time with his kids and his wife. Hopefully, this gave them an anchor of joy in the midst of this really tough time." On July 14, Mike died peacefully at home, surrounded by his loved ones.

Some kids come here for vacation. Others come to die. Either way, parents are grateful USA TODAY, San Leandro, CA; by Madeline Mitchell; 7/20/26 ... There are mainly two kinds of families who come to George Mark's Children's House. Some come for respite, entrusting their medically fragile but otherwise stable children to skilled nurses while parents leave for a much-needed break from around-the-clock caregiving. Others come for pediatric end-of-life care, a rare and essential service that changed the trajectory of CEO Shekinah Eliassen's life. These parents stay with their children at George Mark and can bring the patient's siblings, too, to soak in their last days together. "This type of service, I believe, should be part of the system of pediatrics," Eliassen says, adding that families never see a bill for their visits. Her son, Lars, died at George Mark when he was 21 days old, after he was born having seizures.